Dual Diagnosis

On behalf of the Peel Region Committee for Persons with a Dual Diagnosis, I would like to welcome you to our dual diagnosis website.

This website has been developed for many reasons:

Staff and families want to know what specific programmes are being offered and where. This type of information changes so continually that it is not possible to keep up with it in print. However, our web site features ongoing services and new programmes, with links to the appropriate service providers.

Families want to talk to other families so that they can share ideas, support each other, and exchange information.Since education and training are always rated as crucial issues in the improvement of services to persons with a dual diagnosis, this web site provides information on current best practices, links to training resources such as books and videos, and links to other organizations involved with dual diagnosis.

Staff want the opportunity to talk to staff outside their own agencies, in particular those from the "other" service system. By using this web site they can post questions asking for information/ suggestions. People could discuss coordination of their services. This results in staff being able to support each other and get feedback from someone else who has experience in a specific topic. This would ultimately result in better service provision for clients.

This web site has information pertaining to both Peel and Halton Regions. We hope that you will find it helpful. If you have any questions or information to add, please call the organization that is overseeing the web site, Child Development Resource Connection Peel, at 905-890-9432.

We would like to sincerely thank the Ministry of Community and Social Services and Ministry of Children's Services and the Ministry of Health and Long Term Care which jointly funded the start up of this site. Better communication will lead to better services, a goal we can all support!

Service Description

Assist clients and their care-givers with problem identification and clarification through the gathering of client information and the provision of short-term service coordination.

Assist clients to develop long-term goals, identify appropriate community and specialized support services in order to maximize independence and to increase accessibility of generic services.

Assist clients and their care-givers in the coordination of services. Designated service coordinators provide service coordination as part of interdisciplinary teams with community agencies and service providers or independently, as needed.

Act as advocates for individual clients, or support clients and/or care-givers in their role as an advocate.Work collaboratively with other community agencies to develop and maintain a continuum of coordinated services.

Parent Resources Chapter 2: Understanding Professionals

(Information taken from STRATEGIES A Practical Guide For Dealing With Professionals And Human Service Systems.Written by: Craig V. Shields. Published by: Human Services Press 1995)

Remember that a professional is someone who has chosen to provide services of a particular nature in exchange for payment. If this exchange is to be truly useful, the professional needs to be a resource to you, your child, and family.

Remember that professionals tend to be trained into specific orientations or "schools of thought" within their profession. Ask them to be explicit about their particular orientation and make you aware of alternative approaches.

Accentuate the positive and keep the negative in perspective.

As far as possible, select professionals who demonstrate through their actions a concern for you, your child and family.

Where access to a professional is difficult:- Discuss with the professional at the outset your respective expectations regarding access.- If you want to speak directly to the professional, ask the person acting as intermediary to simply have the professional call you; don't give any further explanation.- If you're having difficulty getting the professional's time, take the initiative and request to meet by a certain date; and you specify how much time you think you'll need.- Let the professional know if you're having problems getting through, and ask what to do in the future to avoid delays.

Where you suspect that information is being withheld from you:- Find out your rights regarding access to information.- If the information is in a report, ask to see the report, even if you can't have a copy.- If you're not allowed to see the report, ask that it be paraphrased or interpreted to you.- If the report was generated elsewhere, go back to the originating source and request a copy

Where you feel that you are not being involved in decisions that affect you, your child or family:- Let the professional or professionals know that you want and expect to be involved.- Anticipate decisions that will need to be made, and request to be involved.- If no alternatives are given to the preferred decision, ask the professional(s) to provide alternatives, and /or seek advice from other professionals regarding alternatives.- If decisions appear to be linked, ask the professional(s) to separate them so they can be considered initially on their individual merits.

Where a professional uses technical terms you don't understand:- Ask them to explain the term in simple English.- Or where possible, ask them to show you what the term means rather than tell you.

Never relinquish responsibility for your child or for looking after your child's best interests.

Be alert to when professionals feel threatened and try to discover the ways in which they protect themselves at such times.

If you feel a professional is either avoiding you or delaying a decision or meeting:- Write to them suggesting specific arrangements for a telephone call or meeting.- Contact a person or group to whom or to which the professional reports and express your concerns

If you suspect that a professional is bluffing:- Note the incident and go on, if the matter isn't serious. Later try to get at the truth.- If the issue is serious, first try to encourage and allow the professional to change their position without losing face;- If this doesn't work, challenge the professional, but try to keep the focus on facts and make sure you have your facts straight and well documented.

Where you feel a professional is trying to put you on the defensive: ignore those comments that you can; and otherwise keep the discussion focused on current or future needs and responsibilities, rather than debating the past or any accusations

Where you suspect that a professional is trying to out-talk you by using technical language or information, place the responsibility back on them to help you understand what they are saying.

Where you suspect that a professional is pulling rank, try to keep the focus on the matter at hand, be persistent, and avoid getting into a power struggle over status.

Where you are dealing with two or more professionals at the same time, be as involved and well-informed as possible, and always retain responsibility for looking after your child's best interests.

Parent Resources Chapter 3: Knowing The System

Get to know the admission criteria, programs, and service philosophies of all relevant agencies.

Be persistent, systematic and well organized in your approach to learning "the system."

Keep informed about the system's activity on your behalf.

Be persistent in your efforts to make the system respond to your child's and family's unique needs.

You are your own best advocate; in order to look after your own interests: be well-informed, stay involved, and participate.

Place responsibility on professionals to deal with their differences of view: If the different views are separated by time, ask the current professional to explain the discrepancy; if you're not satisfied, contact the previous professional for their explanation. Or, particularly if the differences seem important, request that the relevant parties contact one another or get together to try to resolve their differences.

If you feel that the professionals providing you with service are working in either isolation or opposition, begin by finding out: The standards and expectations for professional cooperation; The normal decision-making process and any appeal process; The way in which conflict between professionals and /or agencies is to be resolved then bring your concerns and understanding of the way things should work to the attention of those involved and /or their superiors.

Respect, and reinforce in the view of others, your child's uniqueness and individuality, and the uniqueness of your situation.

Be alert to the system's tendency to protect its own interests; be persistent in your role of advocate for child's and your family's best interests.

Parent Resources Chapter 4: How to Begin

Seek out and explore the support groups and publications related to your child's needs.

Be well informed on normal child development, the nature of your child's exceptionality, and the possible implications the latter might have for your child's development.

When gathering information on services and agencies:- Begin by talking with people you know, both professionals and non-professionals;- Find out whether there are parent support groups on information resources (such as telephone information services or directories of agencies) in your community, and use them;- Develop a list of knowledgeable and helpful people who can provide you with accurate information on services and agencies;- Check and double-check the accuracy of the information you're given.

Be well informed on your rights and the rights of your child with regard to such things as:- Eligibility criteria for services- Confidentiality and access to information- Informed consent and participation in decisions- Grievance procedures and rights of appeal- Policies, principles and standards governing service delivery and professional practice.

Wherever possible when gathering information, try to confirm its accuracy from at least two independent sources.

Keep a record of all contacts with professionals or agencies. Include the date and type of contact, the person's name title, and a summary of the important points discussed.

Keep copies of all information you generate (such as correspondence), or provide (such as completed questionnaires, signed consent or admission forms.)

Request, in writing, copies of all relevant written reports, case histories or summaries generated by others about your childs or family.

Request, in writing, documentation of all relevant recommendations, conclusions, or decisions (and where possible, the reasons for these) made by others regarding your child or family.

Request that the relevant points of all meetings you attend be recorded, and that this record be distributed to all participants.

If there is no written record of a meeting, summarize your understanding of the relevant points in a letter, and ask for confirmation of their accuracy from the chairperson or other participants.

Develop a records file for storing all material related to your child's development and services history.

Set up a contacts sheet and get used to using it to record:- Date (and possibly time) of contact- Name and position of the person contacted- Agency affiliation, telephone number (and address where necessary)- Important points of discussion- Any other details you think are relevant and worth recording

Parent Resources Chapter 5: Selecting Professionals and Agencies

Chapter 5: How to Select Professionals or Agencies

When considering whether to apply for service, ask yourself the following questions:- Does my child really need a service?- What are the potential benefits and risks of the service in question? Of the alternatives to the service?- Could the service be provided in a more normal way?- Which choice appears to be in my child's best short-term interest? Best long-term interest?

When selecting a professional or agency for your child or family:- Begin by identifying the alternatives- Talk with others who have had experience with the alternatives- Get a first-hand impression by meeting or visiting the professionals or agencies.

In making a decision regarding a service, consider your child's overall development needs and long-term interests.

Involve your child in the selection of services where appropriate, and respect his or her point of view.

After you've done all you can do, trust your judgment and intuition when selecting a professional or agency.

When gathering information on professionals and agencies, treat the views and experiences of others as simply pieces of information which may be useful along with other considerations in making your selection decision.

Parent Resources Chapter 6: How to Deal with Professionals

Chapter 6: How to Deal with Professionals

In preparing for a meeting try to have the following clarified: the day, date, time frame, and place of the meeting; the purpose and participants; and whether you need to bring any materials or will receive any written account of the meeting.

Before the meeting write down: any points you'd like discussed; questions you'd like answered; or decisions you'd like made.

Make certain that the agenda for the meeting allows time for your items to be raised and discussed.

Require professionals to be clear regarding the purpose for assessment: why it's needed, what information it will provide, and how that information will be used on behalf of your child.

When deciding upon an assessment service, select in favor of the most normal setting and approach available which can obtain the necessary information.

Ask to observe the actual assessment, wherever appropriate and possible.

Wherever possible, select in favor of an assessment service which provides both a feedback session to parents and a written report.

Make sure that the assessment report provides a balanced profile of your child's abilities. If it doesn't, request that the report be amended or rewritten.

Be cautious regarding the results of any assessment; don't read more into it than is there.

When attending meetings and conferences be sure to record the following:- The date and place of the meeting- The names and affiliations of all participants- Relevant points of information, decisions or disagreement- The date and details of any future meetings.

When attending meeting and conferences ask participants to clarify any terms, concepts or points you don't understand.

At the end of a meeting or conference, if it hasn't been done already, ask for a summarization of decisions regarding who will be doing what and by when.

As far as possible, make sure that services goals are focused upon the person receiving services, and that they are stated in a clear, precise and positive manner.

As far as possible, make sure that all commitments made by professionals include reference to a target deadline.

As far as possible, make sure that all commitments made include identification of the person or persons responsible for seeing that they are carried out.

In general, when faced with any type of impasse:- Keep the focus on the child's best interests- Emphasize what's right rather than who's right- Begin with areas of agreement among participants and work from there.

When faced with an impasse resulting from differing views of "reality," begin by accepting all views as equally valid, then explore ways of understanding why they differ.

When faced with an impasse resulting from preconceived limits, begin by identifying the ideal response given the concerns, then work back to the possible.

When faced with an impasse resulting from unknown obstacles try to find out what the hidden issues are through off-the-record conversations with key participants, and then work from there.

When faced with an impasse resulting from the intransigence of a particular individual, try asking the person what they would do if they were in your place. If this doesn't work, consider the following:- Switching professionals or agencies- Appealing to someone higher up in the organization- Lobbying other professionals to get them to influence or overrule the intransigent person- Going outside the system for the support.

Where you have concerns regarding some aspect of human services, begin by addressing those concerns through appropriate channels within the system.

If your concerns are not resolved from within the system, consider their seriousness, the strength of your case, the likelihood of success, and possible repercussions of applying pressure on the system.

If warranted, develop a strategy for applying pressure by first identifying the issue(s), focus or target of the pressure, and the type of approach (political, legal, public) to be used.

Recreation

Brampton Parks and RecreationSpecial Needs Social and Sports Programs. Special needs programs are designed to provide participants with the opportunity to make new friends, develop skills and have fun.

Mississauga Parks and RecreationSpecial Needs Social and Sports Programs. Special needs programs are designed to provide participants with the opportunity to make new friends, develop skills and have fun.

Ontario Special OlympicsDescription of programs and events across the province. No information specific to Halton/Peel. Contact information provided for each of the regional coordinators.

Funding Sources

Ministry of CitizenshipLists supports currently available for Ontarians with disabilities. Includes detailed information on the Ontario Disability Support Program, Ontario Tax Credits/Exemptions, Elementary/Secondary School Programs and Services, Supports for People with Developmental Disabilities, Home Care, Attendant Services/Outreach, Acquired Brain Injury Services and Children's Treatment Centres.

Ministry of Children & Youth ServicesPublications available include:Special Services at Home & Assistance for Children with Severe Disabilities.Assistance for Children with Severe Disabilities